Traditional and novel imaging modalities for advanced prostate cancer: A critical review

Abstract

Accurate detection of metastatic prostate cancer in the setting of preoperative staging as well as posttreatment recurrence is crucial to provide patients with appropriate and timely treatment of their disease. This has traditionally been accomplished with a combination of computed tomography, magnetic resonance imaging, and bone scan. Recently, more novel imaging techniques have been developed to help improve the detection of advanced and metastatic prostate cancer. This review discusses the efficacy of the traditional imaging modalities as well as the novel imaging techniques in detecting metastatic prostate cancer. Articles discussed were gathered through a formal PubMed search.

Keywords: Imaging; metastatic; prostate cancer.

Figure 1

(a) Pt. is 66-year-old male with a history of Gleason 4+3 prostate cancer s/p = status post radical prostatectomy in 2013 followed by salvage radiation therapy. Patient presented with rising prostate-specific antigen and underwent Fluciclovine positron emission tomography scan for restaging. Imaging demonstrates abnormal Fluciclovine uptake involving R external lymph node, consistent with metastasis. Patient underwent salvage LN dissection and pathology of metastasis was confirmed. (b) Patient is 66-year-old male with a history of Gleason 4+3 prostate cancer s/p radical prostatectomy in 2013 followed by salvage radiation therapy. Patient presented with rising prostate-specific antigen and underwent Fluciclovine positron emission tomography scan for restaging. Subtle increased uptake in R aspect of sacrum, representing possible early bone metastases